8/12/2019 Differential Diagnoses - Trichotillomania

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Differential Diagnoses:

Alopecia Areata - Alopecia areata is a recurrent nonscarring type of hair loss that can affect any hair-

bearing area and can manifest in many different patterns.

Rule In Rule Out

Hair loss Clearly demarcated round or oval patches of hair

loss

Tinea Capitis Ringworm - Tinea capitis is a disease caused by superficial fungal infection of the skin of

the scalp, eyebrows, and eyelashes, with a propensity for attacking hair shafts and follicles

Rule In Rule Out

Hair loss Round scaling patches of alopecia

Hairs are broken off close to the surface of the

scalp

OCD - Obsessive-compulsive disorder (OCD) is characterized by distressing, intrusive obsessive thoughts

and/or repetitive compulsive physical or mental acts.

Rule In Rule Out

Compulsive activity of hair pulling Experiences obsessive thoughts

Factitious Disorder - Factitious disorder refers to the psychiatric condition in which a patient deliberately

produces or falsifies symptoms of illness for the sole purpose of assuming the sick role.

Rule In Rule Out

Hair pulling do not acknowledge the self-inflicted nature of the

lesions

Trichotillomania - Hair loss from pulling, plucking, or twisting hair.

Rule In Rule Out

Hair loss

Hair shafts are broken and of varying lengths.

More common in children, often in settings of

family or psychosocial stress.